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Cost-effectiveness analysis of individual-level obesity treatment in paediatrics: A scoping review
Ashwin Dhillon1, Madeline Mayer1, Lynn Kysh2
1Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, California, USA.
Insights
This review found that individual paediatric obesity treatments, particularly behavioural interventions, are cost-effective. Future research should address methodological challenges in economic evaluations for better decision-making.
Area of Science:
- Health Economics
- Paediatric Obesity Treatment
- Intervention Cost-Effectiveness
Background:
- Paediatric obesity is a growing public health concern requiring effective and economically viable treatment strategies.
- Health economics provides a framework for evaluating the value of healthcare interventions, including those for childhood obesity.
- Understanding the cost-effectiveness of different paediatric obesity treatments is crucial for resource allocation and clinical decision-making.
Purpose of the Study:
- To conduct a scoping review on the health economics of paediatric obesity treatments.
- To identify recently published research on the cost-effectiveness of interventions for paediatric obesity.
- To determine the key characteristics of cost-effective paediatric obesity interventions.
Main Methods:
- A systematic search of six databases (Medline, Embase, Cochrane CENTRAL, CINAHL, PsycINFO) was conducted up to March 2023.
- Included studies focused on individual-level, weight management interventions (behavioural, pharmacotherapy, surgical) for youth aged 2-21 years with obesity.
- Studies involving cost analysis were eligible for inclusion.
Main Results:
- Out of 4371 records, 39 studies met the inclusion criteria, predominantly from high-income countries and published after 2010.
- Thirty-five studies (90%) assessed lifestyle interventions, with 30 (85%) found to be cost-effective.
- Four studies (10%) assessed surgical interventions, all of which were reported as cost-effective. No pharmacotherapy studies met the criteria.
Conclusions:
- Individual-level paediatric obesity treatments, especially behavioural interventions, demonstrate cost-effectiveness and potential cost-savings.
- Economic evaluations of paediatric obesity interventions face methodological challenges that require further research.
- Addressing these challenges will enhance the utility of economic evaluations in guiding decision-making for paediatric obesity treatment.
Objectives:
This scoping review informs a health economics perspective on the treatment of paediatric obesity. The results detail recently published research findings on the cost-effectiveness of paediatric obesity treatments and identify key characteristics of cost-effective interventions.
Methods:
A structured search was applied to six databases with no data restriction through March 2023: Medline, Embase, Cochrane CENTRAL, CINAHL, and PsycINFO. Studies that included a cost analysis of an individual level, weight management intervention (behavioural, pharmacotherapy, and surgical) in youth, with obesity, ages 2 to 21 years were eligible for inclusion.
Results:
Of the 4371 records identified in the initial search, 353 underwent full-text review, 39 studies met the pre-specified inclusion criteria. The majority were published after 2010 (n = 36/39, 92%) and applied to high-income countries (n = 39/39, 100%). Thirty-five of the studies assessed the cost-effectiveness of lifestyle interventions (90%), and four studies assessed surgical outcomes (10%). No pharmacotherapy studies met eligibility criteria. Although the outcome measures differed across the studies, all four surgical interventions were reported to be cost-effective. Thirty of the 35 (85%) lifestyle modification studies were reported to be cost-effective compared to the study comparator examined.
Conclusions:
There is a small amount of evidence that individual-level paediatric obesity treatment interventions are cost-effective and, in some cases cost-saving, with most of this work conducted on behavioural interventions. The economic evaluation of paediatric obesity interventions poses various methodologic challenges, which should be addressed in future research to fully use the potential of economic evaluation as an aid to decision-making.
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